Application and Qualification
Nursing homes are pricey, but did you know your loved one could use Medicare to defray the expenses? Read on to see if this option is available to you.
Medicare is an entitlement program for which eligibility is based upon prepayment through employment or self-employment taxes.
Video: Medicare Ranks Nursing Homes
The Medicare website offers a comprehensive look at the application process. The program is designed to serve the following populations:
People aged 65 or older- People under the age of 65 with certain disabilities
- People of all ages with end-stage rental disease, or permanent kidney failure that requires dialysis or a kidney transplant
The Social Security Administration also has information about applying for and enrolling in Medicare. If your loved one is already receiving Social Security benefits, he or she will automatically be enrolled. Your loved one should contact Social Security about applying if he or she is:
- A disabled widow or widower between 50 and 65 who has not yet applied for disability benefits because he or she already receives Social Security
- A government employee who became disabled before 65
- A person with kidney failure, or has a spouse or dependent child with kidney failure
- Had Medicare insurance but dropped it in the past
- Turned down Medicare insurance upon becoming entitled to Medicare Part A (hospital insurance)
Medicare Components
Medicare offers several components, some of which are particularly relevant to nursing-home expenses:
- Part A: Hospital insurance, which is prepaid through payroll taxes from you or a spouse and generally requires no premium.
- Part B: Medical insurance, which usually requires a monthly premium to help cover medical services and outpatient care, as well as various medical services not covered by the hospital-insurance component.
- Part D: Prescription drug coverage, which is available as of Jan. 1, 2006. This can help insulate against increased drug costs while lowering the price paid for prescriptions, and is provided by private companies.
Enrollment in Part A is automatic if your loved one or their spouse has worked for a Medicare-covered job for more than 10 years. If they are not eligible for automatic enrollment, they can apply during a seven-month initial enrollment period, which begins three months after turning 65.
If your loved one is already receiving Social Security benefits or benefits from the Railroad Retirement Board, he or she will automatically be enrolled in Medicare Part B on the first day of the month they turn 65. As with Part A, those who are not automatically enrolled can apply during their seven-month initial enrollment. The general enrollment period is between January 1 and March 31 of each year. To enroll in Part B, contact Social Security at (800) 772-1213.
Video: Choosing a Nursing Home
What If Medicare Goes Bankrupt?
With talk of Medicare possibly facing insolvency by the year 2020, your loved one may be worried about the security of his or her benefits.
Medicare experts say this may be unlikely given the huge lobbying effort put forth by the American Association of Retired Persons, as well as a renewed focus on healthcare on the part of the White House. The Cato Institute says that Part D is entirely funded through different means, and like Part B’s outpatient doctor program, will be supported largely through taxes and premiums paid by beneficiaries.
The bottom line: Medicare may be in difficult financial straits, but it’s fairly certain that your loved one’s benefits remain safe. However, stay informed for the latest developments so that you can plan ahead.